Assisted Reproductive Technology (ART) includes in vitro fertilization-embryo transfer (IVF-ET), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), tubal embryo transfer (TET), and frozen embryo transfer (FET). These techniques also apply to oocyte donation and gestational carriers. These are relatively new procedures for couples who are unable to conceive by other methods. Although ART has helped many people overcome their infertility, they are not the answer for every infertile couple. Most of the time we use ART only when less complex and less expensive methods of treatment have failed. However, in certain circumstances (such as advanced age or severe male factor) we may recommend ART as first-line therapy.

IVF, GIFT, ZIFT, and TET are very similar procedures although there are a few significant differences. During IVF-ET, ZIFT, and TET, the oocytes and sperm are combined in a culture dish in the laboratory. Fertilization and very early embryo development occur outside the body, rather than in the fallopian tube. Once early embryo development is recognized, the embryos are transferred either into the uterus (IVF-ET) or the fallopian tube (ZIFT, TET). Since most programs have seen no significant difference in success rates, they usually perform IVF-ET because it is less expensive and doesn't require laparoscopy and general anesthesia. In addition, IVF-ET is the only procedure available for women with damaged fallopian tubes.

GIFT differs from the other procedures in that sperm and oocytes are transferred into the fallopian tubes immediately after oocyte retrieval. Fertilization thus occurs in the body, rather than in the laboratory. GIFT originally was thought to represent a breakthrough in infertility therapy. National ART statistics suggest that success rates are higher with GIFT than IVF-ET. However, many investigators have concluded that GIFT does not increase the likelihood of conception compared to other ART procedures, and that the statistics may reflect differences in laboratory expertise or in the kinds of patients treated with GIFT versus IVF-ET. In addition, GIFT does not allow for confirmation of successful fertilization if the procedure does not produce a pregnancy. Because of these disadvantages, most programs do not perform GIFT. Your physician will discuss each of these procedures with you so that the most appropriate procedure for your individual situation will be used.

Couples who are considering ART should realize that it is an intensely emotional, physically arduous, and expensive procedure. Most couples find it difficult to consider the chances for success realistically without dampening the drive that allows them to undertake these procedures. Above all, couples should explore plans for the future, whether or not their attempts at ART are successful.